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* 1. Please provide the name, jobsite and position of the person filling out this form.

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* 2. Please provide a phone number tht the Awards Committee could use to contact you outside of school hours if we need any further information about this nomination.

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* 3. Is this nomination of a peer, or a self-nomination?

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* 4. Please provide the seconder's name, jobsite and position.

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* 5. Name(s), jobsite(s) and position(s) of nominee(s) - Please note: if this was a group project, please nominate the leaders or top contributors to the project or activity.

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* 6. Please select the award(s) for which the nomination may be considered.
Check all that apply.

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* 7. Give a short description of the activities or services for which you are putting forth this nomination. What are the reasons that you decided to seek an award for the nominee(s). *Point-form is great.*

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* 8. What has been the timeline or duration of the service or activities?

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* 9. Use the checkboxes below to report the impact of the service or activities of the nominee(s). You may select all checkboxes that apply. Who benefitted from the service or activities?

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* 10. If applicable, how have the actions of the nominee(s) assisted the local (GEETF) and its members?

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* 11. If applicable, how have the services or activities impacted the wider community?

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* 12. Is there anything else you would like us to know about the impact of this project?

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